2024 FRACTURES AND
AMPUTATIONS- (IN CLASS)
NCLEX EXAM WITH CORRECT
ANSWERS
The patient is brought to the emergency department after a car accident and
has a femur fracture. What nursing intervention should the nurse implement
to prevent a fat embolus in this patient?
a. Administer enoxaparin (Lovenox).
b. Provide range-of-motion exercises.
c. Apply sequential compression boots.
d. Immobilize the fracture preoperatively. - CORRECT ANSWERS-d.
Immobilize the fracture preoperatively.
To prevent fat emboli, the nurse immobilizes the long bone to reduce
movement of the fractured bone ends and decrease the risk of a fat embolus
from the bone before surgical reduction.
The nurse is completing a neurovascular assessment on the patient with a
tibial fracture and a cast. The feet are pulseless, pale, and cool. The patient
says they are numb. What should the nurse suspect is occurring?
a. Paresthesia
b. Pitting edema
c. Poor venous return
d. Compartment syndrome - CORRECT ANSWERS-d. Compartment syndrome
The nurse should suspect compartment syndrome with one or more of the
following six Ps: paresthesia, pallor, pulselessness, pain distal to the injury
and unrelieved with opioids, pressure increases in the compartment, and
paralysis.
A middle-aged patient has a tight cast on the left lower leg. Which
assessment finding would prompt the nurse to assess further for
compartment syndrome?
A. Diminished pulses
, B. Discoloration of some of the toes
C. Tingling sensation of the upper leg
D. Pain more intense than expected based on initial injury - CORRECT
ANSWERS-D. Pain more intense than expected based on initial injury
The classic sign of acute compartment syndrome is pain, and the pain is
more intense than what would be expected from the injury itself.
he nurse explains that which diagnostic test best demonstrates
musculoskeletal and soft tissue damage?
A. Standard x-rays
B. Electromyography (EMG)
C. Computed tomography (CT)
D. Magnetic resonance imaging (MRI) - CORRECT ANSWERS-D. Magnetic
resonance imaging (MRI)
MRI is useful in determining the amount of soft tissue damage that may have
occurred with the fracture.
54-year-old man presents to the ED with a deformed right ankle. He states
that he was jogging close to the edge of a hillside, and that he tripped and
fell down the hill. There are no openings in the skin. A pulse cannot be
obtained by touch to the right foot, which is pale and cool to palpation. The
patient rates his pain as an "8" on a 0-to-10 scale. What is the priority
nursing action at this time?
A. Administer pain medication.
B. Prepare for reduction.
C. Obtain a Doppler of the right foot pulse.
D. Notify the physician of the lack of a pulse in the right foot. - CORRECT
ANSWERS-C. Obtain a Doppler of the right foot pulse.
The nurse should obtain a Doppler reading to see if any pulse can be
detected at all.
An ankle x-ray confirms that the patient has an ankle fracture. A fiberglass
cast is applied to immobilize the ankle and allow for healing. Which are
priority interventions after the cast is applied? (Select all that apply.)
A. Monitor for signs of infection.
B. Assess peripheral capillary refill.
C. Ask the patient about frequency of bowel movements.
D. Keep the cast uncovered for air-drying over several hours.
E. Insert a finger between the skin and the cast to be sure the cast is not too
tight. - CORRECT ANSWERS-A. Monitor for signs of infection.
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